Cognitive impairments associated with meningiomas and gliomas in adults: A systematic review

Meningiomas and gliomas are common adult brain tumors often linked to cognitive impairments. Meningiomas are frequently overlooked as a potential contributor to such impairments, due to their benign, extra-axial, and slow-growing nature. This systematic review compares the type and frequency of cognitive impairments associated with these brain tumors, prior to any therapeutic intervention.

Systematic search conducted in ProQuest, PubMed, Scopus, and Cochrane Library identified records on cognitive status of adults with untreated, nonrecurrent gliomas or meningiomas, published between January 01, 2000 and October 01, 2025. Studies using a comprehensive, test-based cognitive evaluation and strict exclusion criteria were included.

Seventy studies (4,277 patients) with minimal risk of bias met the inclusion criteria. Although cross-study comparisons were hampered by heterogeneity in statistical thresholds, reported metrics, inclusion criteria, and neuropsychological assessments, the findings consistently indicated significant impairments across multiple cognitive domains, with comparable prevalence in gliomas and symptomatic meningiomas. Memory and executive impairments prevailed in gliomas, while executive and attentional impairments predominated in meningiomas.

Cognitive impairments are highly prevalent in patients with symptomatic meningiomas or gliomas. While gliomas do not consistently result in a higher frequency of impairments, this review highlights slight differences in the cognitive domains affected. The role of tumor growth and intra-axial location in cognitive outcomes remains unclear. Comparative studies based on strict inclusion/exclusion criteria and comprehensive neuropsychological evaluations are essential for a better understanding of the pathophysiology of cognitive impairments associated with primary brain tumors. Existing guidelines should be followed to harmonize assessments and enable comparisons. (PsycInfo Database Record (c) 2026 APA, all rights reserved).